Tracheostomy management in Acute Care Facilities - a matter of teamwork

• Published in: Journal of clinical nursing 2010-05, Vol.19 (9-10), p.1275-1283
• Main Authors: Parker, Vicki, Giles, Michelle, Shylan, Gai, Austin, Nicole, Smith, Kelvin, Morison, Jane, Archer, Wendy
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Clinical medicine; Clinical outcomes; Female; Focus Groups; Humans; Intensive care; Intensive Care Units; inter-disciplinary team; Length of Stay; Male; Medical procedures; Middle Aged; mixed method evaluation; New South Wales; nurses; Nursing; Patient Care Team; Quality of care; Throat; Tracheostomy
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/j.1365-2702.2009.03155.x

Aim.  Implement and evaluate an inter‐disciplinary team approach to tracheostomy management in non‐critical care. Background.  Trends towards early tracheostomy in intensive care units (ICU) have led to increased numbers of tracheostomy patients. Together with the push for earlier discharge from ICU, this poses challenges across disciplines and wards. Even though tracheostomy is performed across a range of patient groups, tracheostomy care is seen as the domain of specialist clinicians in critical care. It is crucial to ensure quality care regardless of the patient’s destination after ICU. Design.  A mixed method evaluation incorporating quantitative and qualitative approaches. Method.  Data collection included pre‐implementation and postimplementation clinical audits and staff surveys and a postimplementation tracheostomy team focus group. Descriptive and inferential analysis was used to identify changes in clinical indicators and staff experiences. Focus group data were analysed using iterative processes of thematic analysis. Results.  Findings revealed significant reductions in mean hospital length of stay (LOS) for survivors from 50–27 days (p